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Emergency Medical Technician - Basic
Health Science Core
Infectious Disease
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Revised: August 2007
Exposure Types
Non-Significant – Occupational exposure
that have little to no risk of transmission of
disease known at the time.
Significant – Occupational exposure that has
increased risk transmission and acquiring
of disease
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Revised: August 2007
Significant Exposure based on contact with
bodily fluid and injury
Fluids
• Blood, serum, or plasma
• Pleural, amniotic,
pericardial, peritoneal,
syovial, or cererospinal
fluid
• Vaginal secretions or
semen
• Saliva
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Injuries
• Percutaneous – needle
stick, laceration,
abrasion, or bites
• Mucous membrane –
eyes, nose, or mouth
• Skin – cut or abraded
skin (not intact)
Revised: August 2007
Significant Air or Droplet Exposure
Combination of a subject
showing signs or
symptoms of suspected
airborne illness and
performing activity that
exposed the EMT to
droplet or airborne
contaminants.
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Activity
• Gag/cough reflex
• Manual suctioning of
naso-pharyngeal airway
• Insertion of nasogastric,
supraglottic, or intubation
tube
Revised: August 2007
Post Exposure
• Provide first aid (if necessary, for example)
– Remove contaminated clothing
– Flush site contaminated fluid
– Clean site with soap/water or antiseptic
• Notification and relief of duty
• Obtain medical attention at medical facility
• Document
• Possible need to do follow-up testing months
later
McFatter Technical Center
Revised: August 2007
HIV/AIDS
McFatter Technical Center
Revised: August 2007
HIV
Human Immunodeficiency Virus
A virus that attacks
and destroys the
immune system
making the
patient vulnerable
to any infection.
McFatter Technical Center
Revised: August 2007
AIDS
Acquired Immune Deficiency Syndrome
A specific group of
diseases or
conditions which are
indicative of severe
immunosuppression
related to the HIV
infection.
McFatter Technical Center
Revised: August 2007
HIV/AIDS
• Normal T-cell count for a healthy adult is between 8001000 T-cells per cubic millimeter of blood.
• A patient infected with the HIV virus usually has a T-cell
count less than 200 T-cells per cubic millimeter of blood.
• HIV then attacks, enters, and destroys these T-4 cells.
• Without T-4 helper cells, the elimination process cannot
occur.
• The patients defense system known as the immune
system, is now destroyed and unable to prevent further
illnesses.
McFatter Technical Center
Revised: August 2007
HIV/AIDS
• America’s first case was diagnosed in 1981
• Many cases are just not reported
• 50% of those that are infected with HIV will generally
develop some signs and symptoms within 5 years
• The most recent reports of AIDS/HIV cases suggest that:
• ½ cases are among men who have sex with other men
• ¼ cases are among intravenous drug use
• ¼ cases are among heterosexuals
McFatter Technical Center
Revised: August 2007
HIV/AIDS
• Mortality is high upon progression
of disease.
• 80-90% of patients diagnosed with
AIDS, will die within 3-5 years of
diagnosis due to complications
associated with the disease.
• With advancements in medications
and treatments, early intervention
can increase the quality of life and
possibly increase the longevity of
those infected.
McFatter Technical Center
Revised: August 2007
HIV/AIDS
Transmission
• Sexual contact with an infected
person
• Blood to blood
• intravenous drug use (IDU)
• Pregnancy and breastfeeding
• Transfusions, but since blood
screening in the early 90’s, risk
has been greatly diminished.
McFatter Technical Center
Revised: August 2007
Bodily Fluids with HIV
• Transmittable amounts:
• Blood
• Semen
• vaginal secretions
• breast milk
• Non-transmittable amounts:
• Saliva
• Urine
• tears
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Revised: August 2007
HIV/AIDS
Not Transmitted by:
•
•
•
•
•
•
casual contact
handshaking
hugging
kissing
animals
insects
McFatter Technical Center
Revised: August 2007
HIV/AIDS
Signs / Symptoms
• fatigue
• continuos flu-like
symptoms
• weight loss
• night sweats
• grayish-purple lesions
called Karposi’s
Sarcoma
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Revised: August 2007
HIV/AIDS
Protection
• Gloves
• Double gloves to prevent cross contamination.
• Mask due to possible associated airborne
diseases
• Isolation gown for rescue personnel that have any
open wounds
• Hands washed with a anti-microbial agent.
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Revised: August 2007
Tuberculosis
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Revised: August 2007
Tuberculosis
• A bacterium that infects the
alveoli
• Not everyone infected develops
the full-blown disease, latent TB
infection is most common.
• However, one in ten latent
infections will progress to active
TB disease, which, if left
untreated, kills more than half of
its victims.
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Multiple Drug Resistant Tuberculosis
• A form of TB resistant to antibiotics.
• Strain developed from patients that did not
finish taking the antibiotics and not killing off all
of the bacteria
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Tuberculosis
Transmission
Droplets are so small,
they remain airborne
for extended periods
of time and breathed
into the lungs
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Revised: August 2007
Tuberculosis
Signs and Symptoms
•
•
•
•
•
•
•
cough for greater than 2 weeks
unexplained weight loss
night sweats
loss of appetite
fever
coughing of blood (hemoptysis)
fatigue
McFatter Technical Center
Revised: August 2007
Tuberculosis
Protection
• TB/Hepa protective
masks on both the patient
and yourself
• open all windows to
enhance ventilation and
reduce exposure of
airborne particles
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Revised: August 2007
Tuberculosis
Testing
•
•
•
•
PPD SKIN TESTING
Mantoux PPD (Purified Protein
Derivative) skin test is an injection
of a small amount of fluid under the
skin.
results 48 to 72 hours
possible exposure - bubble swells
and hardens
verify infection - 6 months chest xrays and re-administer the test
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Revised: August 2007
Hepatitis
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Hepatitis
• Effects the liver by inflammation
• Viral Hepatitis refers to several common diseases that lead
to the swelling and tenderness of the liver which includes:
• Hepatitis A (HAV)
• Hepatitis B (HBV)
• Hepatitis C (HCV)
McFatter Technical Center
Revised: August 2007
Hepatitis
Signs and Symptoms
• jaundice, especially in
the eyes
• fatigue
• abdominal pain
• loss of appetite
• intermittent nausea
• diarrhea
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Revised: August 2007
Hepatitis A
Transmission:
• Infection contracted by food or
water contaminated by human
waste
Prevention:
• Hepatitis A vaccine
• Proper hygiene and sanitation
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Revised: August 2007
Hepatitis B
Transmission:
• bloodborne pathogens
• sexual contact with an infected person
• perinatal
• contaminated needles
Prevention:
• Hepatitis B vaccine
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Revised: August 2007
Hepatitis C
Transmission:
• bloodborne pathogens
• sexual contact with an infected person
• perinatal
• contaminated needles
Prevention:
• No vaccine
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Influenza
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Revised: August 2007
Influenza
• Other names:
– Flu
– seasonal Flu
– pandemic Flu
• Transmission:
– airborne
• Cause mild to severe illness and/or death
• Symptoms 1-3 days after exposure
• Prevention:
– Yearly vaccination
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Revised: August 2007
MRSA – Methicillin-resistant
Staphylococcus Aureus
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Revised: August 2007
MRSA
• Transmission:
– skin to skin contact with infected person
– Skin contact with object that was exposed to
bacteria
• Cause minor infection to fatal bloodstream
infection
• Prevention:
– Gloves and washing hands
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Revised: August 2007
Meningitis
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Revised: August 2007
Meningitis
Inflammation of the protective membranes
covering the central nervous system know
as meninges.
Cause can be from infectious agent,
physical injury, cancer, or certain drugs
McFatter Technical Center
Revised: August 2007
Meningitis Signs and Symptoms
• Most common symptom headache (87%)
• Stiffness of the neck (83%) – unable to flex neck
forward
• High fever
• Altered mental status
• Photophobia – intolerance to bright light
• Phonophobia – intolerance to loud noise
• Irritability and delirium in small children
• Swelling of fontanelle in infants
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Revised: August 2007
Meningitis –
Bacterial Meningitis
• Medical emergency and high mortality rate
• Causes are typically microorganisms of
meningococcus and pheumococcus
• Treatment various antibiotics depending on age
and type of bacterium
• Transmission – respiratory and throat secretions
from coughing or kissing
• Prevention:
– Certain strain have vaccines
McFatter Technical Center
Revised: August 2007
Meningitis –
Viral Meningitis
• Serious but rarely fatal with patients with normal
immune systems
• Antibiotics have no effect on virus
• Causes - enteroviruses
• Treatment – none
• Prevention:
– Washing hands
– Cleaning contaminated surfaces
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Revised: August 2007
Reference
• Florida Regional Common EMS Protocols.
Jones and Bartlett. Boston: 2004.
• www.cdc.gov
• www.wikipedia.com
McFatter Technical Center
Revised: August 2007